Froedtert Holy Family Memorial Hospital — price list
← Hospital overviewVerified from Froedtert Holy Family Memorial Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
14 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| diazePAM 5 MG/ML Solution 10 mL Vial Inpatient | J3360 HCPCS | $415 | $228 | $208 – $365 | — | |
| HC CARIS IHC QUANT, MORPHMTR ANLYS, TUM, PER SPCMN, EA SGL AB STAIN, MAN Inpatient | 88360 CPT | $180 | $98.73 | $108 – $158 | — | |
| HC CX IN OR PRE PROCEDURE Inpatient | 0360 RC | $1,481 | $815 | $889 – $1,303 | — | |
| HC ENDO LEVEL 1 BASE, FIRST 15 MIN Inpatient | 0360 RC | $6,316 | $3,474 | $3,790 – $5,558 | — | |
| HC ENDO LEVEL 3 BASE, FIRST 15 MIN Inpatient | 0360 RC | $8,561 | $4,709 | $5,137 – $7,534 | — | |
| HC HYDRATION IV INFUSION, INITIAL, 31-60 MIN Inpatient | 96360 CPT | $648 | $356 | $389 – $570 | — | |
| HC MECONIUM, METHYLPHENIDATE Inpatient | 80360 CPT | $126 | $69.30 | $75.60 – $111 | — | |
| HC METHYLPHENIDATE RITALIN ASSAY Inpatient | 80360 CPT | $191 | $105 | $115 – $168 | — | |
| HC OR ADDL CASE RESOURCES EQUIPMENT Inpatient | 0360 RC | $1,518 | $835 | $911 – $1,336 | — | |
| HC OR LEVEL 1 BASE, FIRST 15 MIN Inpatient | 0360 RC | $4,503 | $2,477 | $2,702 – $3,963 | — | |
| HC OR LEVEL 2 BASE, FIRST 15 MIN Inpatient | 0360 RC | $6,169 | $3,393 | $3,701 – $5,429 | — | |
| HC OR LEVEL 4 BASE, FIRST 15 MIN Inpatient | 0360 RC | $10,004 | $5,502 | $6,002 – $8,804 | — | |
| HC OR LEVEL 4, EA ADDL MIN Inpatient | 0360 RC | $119 | $65.45 | $71.40 – $105 | — | |
| HC OR LEVEL 5, EA ADDL MIN Inpatient | 0360 RC | $133 | $73.15 | $79.80 – $117 | — |